Objective: In many countries, physical education (PE) is taught by classroom teachers (generalists) during the formative years of elementary school. The purpose of this study was to evaluate the physical and psychological outcomes of multi-sports PE taught by qualified PE teachers (specialists) and how they contribute to children's physical and mental health development. Design: Experimental study with non-random assignment. Setting: Four elementary schools in Italy (Rome) stratified by urban district. Method: One hundred and twenty-five upper elementary school children (10-11 years) were assigned to an eight month multi-sports or traditional PE programme taught by a PE specialist or a generalist, respectively. Pre-and post-intervention tests assessed children's fitness (aerobic fitness, abdominal strength and endurance, and hamstring flexibility) and coordination (kinesthetic discrimination ability, response orientation ability), goal (task and ego) orientation, perceived physical ability and social self-efficacy. Multivariate and univariate analyses of variance were performed on physical and psychological test measures. Results: The results demonstrated that the multi-sports approach to PE induced more pronounced improvements in aerobic fitness and kinesthetic discrimination ability, as well as small but significant improvements in task orientation, ego orientation and social self-efficacy, when compared to traditional PE taught by a generalist. Conclusions: A multi-sports approach to elementary school PE contributes to the development of children's physical fitness and goal orientations, which support engagement in physical activity. These findings highlight the role of qualified PE specialists and multi-sport, skill-based curricula to obtain positive physical and psychological outcomes that may facilitate the development of a healthy child. (Contains 1 table and 4 figures.)